Unless our bed partner is disrupting our sleep, most of us don’t think of snoring as something to be overly concerned about. But frequent, loud snoring may be a sign of sleep apnea, a common and potentially serious disorder in which breathing repeatedly stops and starts as you sleep. Although sleep apnea is treatable, it often goes unrecognized. Learn how to recognize the warning signs of sleep apnea, how to distinguish it from normal snoring, and what you can do about it.
What is sleep apnea?
Sleep apnea affects the way you breathe when you’re sleeping. In untreated sleep apnea, breathing is briefly interrupted or becomes very shallow during sleep. These breathing pauses typically last between 10 to 20 seconds and can occur up to hundreds of times a night, jolting you out of your natural sleep rhythm. As a consequence, you spend more time in light sleep and less time in the deep, restorative sleep you need to be energetic, mentally sharp, and productive the next day.
This chronic sleep deprivation results in daytime sleepiness, slow reflexes, poor concentration, and an increased risk of accidents. Sleep apnea can also lead to serious health problems over time, including diabetes, high blood pressure, heart disease, stroke, and weight gain. But with treatment you can control the symptoms, get your sleep back on track, and start enjoying what it’s like to be refreshed and alert every day.
Types of sleep apnea.
Obstructive sleep apnea is the most common type of sleep apnea. It occurs when the soft tissue in the back of your throat relaxes during sleep and blocks the airway, often causing you to snore loudly.
Central sleep apnea is a much less common type of sleep apnea that involves the central nervous system, occurring when the brain fails to signal the muscles that control breathing. People with central sleep apnea seldom snore.
Complex sleep apnea is a combination of obstructive sleep apnea and central sleep apnea.
Anatomy of a sleep apnea episode.
As airflow stops during a sleep apnea episode, the oxygen level in your blood drops. Your brain responds by briefly disturbing your sleep enough to kick start breathing – which often resumes with a gasp or a choking sound. If you have obstructive sleep apnea, you probably won’t remember these awakenings. Most of the time, you’ll stir just enough to tighten your throat muscles and open your windpipe. In central sleep apnea, you may be conscious of your awakenings.
Sleep apnea signs and symptoms.
It can be tough to identify sleep apnea on your own, since the most prominent symptoms only occur when you’re asleep. But you can get around this difficulty by asking a bed partner to observe your sleep habits, or by recording yourself during sleep.
Major signs and symptoms of sleep apnea:
-Loud and chronic snoring.
-Choking, snorting, or gasping during sleep.
-Long pauses in breathing.
-Daytime sleepiness, no matter how much time you spend in bed.
Other common signs and symptoms of sleep apnea:
-Waking up with a dry mouth or sore throat.
-Restless or fitful sleep.
-Insomnia or nighttime awakenings.
-Going to the bathroom frequently during the night.
-Waking up feeling out of breath.
-Forgetfulness and difficulty concentrating.
-Moodiness, irritability, or depression.
Signs and symptoms of sleep apnea in children.
While obstructive sleep apnea can be common in children, it’s not always easy to recognize. In addition to continuous loud snoring, children with sleep apnea may adopt strange sleeping positions and suffer from bedwetting, excessive perspiration at night, or night terrors. Children with sleep apnea may also exhibit changes in their daytime behavior, such as:
-Hyperactivity or inattention
-Developmental and growth problems
-Decrease in school performance
-Irritable, angry, or hostile behavior
-Breathing through mouth instead of nose
If you suspect your child may have sleep apnea, consult a pediatrician who specializes in sleep disorders. Once obstructive sleep apnea is diagnosed, surgery to remove the child’s tonsils or adenoids usually corrects the problem.
Sleep apnea can be a potentially serious disorder, so contact a doctor immediately if you spot the warning signs. An official diagnosis of sleep apnea may require seeing a sleep specialist and taking a home-based sleep test using a portable monitor, or an overnight stay at a sleep clinic.
Is it just snoring or is it sleep apnea?
Not everyone who snores has sleep apnea, and not everyone who has sleep apnea snores. So how do you tell the difference between garden variety snoring and a more serious case of sleep apnea?
The biggest telltale sign is how you feel during the day. Normal snoring doesn’t interfere with the quality of your sleep as much as sleep apnea does, so you’re less likely to suffer from extreme fatigue and sleepiness during the day.
If you’re still unsure whether your snoring is normal or something more serious, the following strategies can help you decipher the symptoms:
Keep a sleep diary – Record how many hours you’re spending in bed, any nighttime awakenings, and whether you feel refreshed in the morning. Ask your sleep partner to keep track of your snoring, including how loud and frequent it is. Also ask him or her to note any gasping, choking, or other unusual sounds.
Record yourself sleeping – Taking a video or audio recording of yourself while you sleep can be very informative and revealing. You can use a sound-activated audio recorder, a video camera, or software that turns your computer into a recorder.
Sleep apnea causes and risk factors.
Anyone can have sleep apnea, young, old, male, female, and even children. However, certain risk factors have been associated with obstructive and central sleep apnea. You have a higher risk for obstructive sleep apnea if you are:
-Related to someone who has sleep apnea
-Over the age of 65
-Black, Hispanic, or a Pacific Islander
Other risk factors for obstructive sleep apnea include certain physical attributes, such as having a thick neck, deviated septum, receding chin, or enlarged tonsils or adenoids (the most common cause of sleep apnea in children). Your airway may be blocked or narrowed during sleep simply because your throat muscles tend to relax more than normal. Allergies or other medical conditions that cause nasal congestion and blockage can also contribute to sleep apnea.
Like obstructive sleep apnea, central sleep apnea is more common in males and people over the age of 65. However, unlike obstructive sleep apnea, central sleep apnea is often associated with serious illness, such as heart disease, stroke, neurological disease, or spinal or brainstem injury.
Self-help treatment options for sleep apnea.
While a diagnosis of sleep apnea can be scary, it is a treatable condition. In fact, there are many things you can do on your own to help, particularly for mild to moderate sleep apnea. Home remedies and lifestyle modifications can go a long way in reducing sleep apnea symptoms.
-Lose weight. Some people find that even moderate to severe sleep apnea can be completely corrected by losing excess weight. For others, even a small amount of weight loss can open up the throat and improve sleep apnea symptoms.
-Quit smoking. Smoking is believed to contribute to sleep apnea by increasing inflammation and fluid retention in your throat and upper airway.
-Avoid alcohol, sleeping pills, and sedatives, especially before bedtime as they relax the muscles in the throat and interfere with breathing.
-Avoid caffeine and heavy meals within two hours of going to bed.
-Maintain regular sleep hours. Sticking to a steady sleep schedule will help you relax and sleep better. Apnea episodes decrease when you get plenty of sleep.
Bedtime tips for preventing sleep apnea:
-Sleep on your side. Avoid sleeping on your back, as gravity makes it more likely for your tongue and soft tissues to drop and obstruct your airway.
-The tennis ball trick. In order to keep yourself from rolling onto your back while you sleep, sew a tennis ball into a pocket on the back of your pajama top. Or wedge a pillow stuffed with tennis balls behind your back.
-Prop your head up. Elevate the head of your bed by four to six inches or elevate your body from the waist up by using a foam wedge. You can also use a special cervical pillow.
-Open your nasal passages. Try to keep your nasal passages open at night using a nasal dilator, saline spray, breathing strips, or a neti pot.
If your sleep apnea is moderate to severe, or you’ve tried self-help strategies and lifestyle changes without success, it’s important to see a doctor. A sleep specialist can evaluate your symptoms and help you find an effective treatment. Treatment for sleep apnea has come a long way in recent times, so take some time to explore the new options. Even if you were unhappy with sleep apnea treatment in the past, chances are you can find something that works and feels comfortable to you.
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